The research subjects were patients admitted to the Intensive Care Units (ICU) of four area hospitals. Oral specimens of plaque and saliva were collected from 152 critically ill patients at three time points. This multi-center study collected patient data from the medical record and utilized assessment scores including Becks Oral Assessment Score, Mucosal Plaque score and the Clinical Pulmonary Infection Score. Initially, at each hospital patients who were recruited served as the baseline for that setting. These patients received the standard oral care at each facility. Education was provided to the nursing staff of the four units on systematic oral care. The timing of this oral care was performed based on oral assessment scores. Patients were then recruited and these patients received the systematic oral care and chlorhexidene spray. Data collection and patient recruitment started in October 2004 and concluded in April 2007. It is hypothesized that there will be a difference in the assessment scores recorded from patients who received the systematic oral care as compared to patients who did not. Data analysis is ongoing.